Portfolio

Cardiac rhythm devices

Implantable pacing devices, defibrillators, resynchronisation devices, monitors, leads and remote follow-up systems.

Where it is used

  • Symptomatic bradycardia and atrioventricular block
  • Prevention of sudden cardiac death in ventricular tachycardia and fibrillation
  • Heart failure with ventricular dyssynchrony
  • Unexplained syncope, palpitations and assessment of atrial fibrillation burden
  • Long-term follow-up of patients with implanted devices

Product types

Pacing systems

Pacing corrects bradycardia by delivering an electrical impulse where the heart cannot reliably generate its own. A single-chamber system places one lead, usually in the right ventricle, and is used mainly when the patient is in permanent atrial fibrillation, where pacing the atrium adds no benefit. A dual-chamber system places leads in both the right atrium and the right ventricle and preserves the timing between them, which is generally preferred for atrioventricular block in a patient who is still in sinus rhythm.

Defibrillation

An implantable cardioverter-defibrillator recognises ventricular tachycardia or fibrillation and delivers a shock to terminate it, something a pacemaker on its own cannot do. Primary-prevention implantation is offered to patients with severely reduced heart function who are at risk of a first arrhythmic event. Secondary-prevention implantation is offered to patients who have already survived a cardiac arrest or a sustained ventricular arrhythmia.

Cardiac resynchronisation

Heart failure is often accompanied by dyssynchrony, where the parts of the ventricle no longer contract in coordinated timing with one another. Resynchronisation therapy places a third lead toward the left ventricle, usually by way of the coronary sinus, and paces both ventricles together to restore coordinated contraction. A device that also carries defibrillation capability is a resynchronisation defibrillator; one that paces only is a resynchronisation pacemaker.

Long-term monitoring

An insertable cardiac monitor records the heart's electrical activity through a single subcutaneous lead for months or years, well beyond the reach of a short-term Holter recording. It is used to investigate recurrent unexplained syncope or palpitations, to track atrial fibrillation burden over time, and in the workup of stroke with no identified cause, where a rare arrhythmic episode needs to be caught over a long observation window.

Leads

Pacing leads deliver the impulse to the atrium or the ventricle, and are distinct from defibrillation leads, which sense the rhythm and also carry the high-voltage shock when one is needed. A lead to the left ventricle has a distinct shape suited to placement through the coronary sinus, because the outer surface of the left ventricle cannot be reached from inside the heart the way the other chambers can.

Implant delivery and follow-up

Delivery tools such as introducers, sheaths and guide catheters help the lead reach its intended position during implantation. After implantation, a programmer reads and adjusts the device's settings during a clinic visit, while a remote monitoring system transmits the device's data from the patient's home to the follow-up centre between visits.

Categories and their use

Cardiac rhythm devices
CategoryUsed for
Implantable pacemakers, single and dual chamberTreatment of symptomatic bradycardia and atrioventricular block
Implantable cardioverter defibrillatorsDetection and termination of ventricular tachyarrhythmia
Cardiac resynchronisation devicesCoordination of ventricular contraction in heart failure with dyssynchrony
Insertable cardiac monitorsLong-term rhythm recording for unexplained syncope and atrial fibrillation burden
Pacing leadsDelivery of the stimulus to the atrium or the ventricle
Defibrillation leadsRhythm sensing and delivery of high-voltage therapy
Left ventricular leadsStimulation of the left ventricle through the coronary sinus
Lead delivery systemsIntroducers, sheaths and guide catheters for lead placement
Programmers and external devicesInterrogation and configuration of implanted devices
Remote monitoring systemsTransmission of device data from the patient's home to the follow-up centre

Every item here is supplied, installed, serviced and supported, with training included at handover.